Evaluation of the utility of computed tomography in the initial assessment of the critical care patient with chest trauma

Guerrero-López, F.; Vázquez-Mata, Guillermo; Alcazar-Romero, Pedro Pablo; Fernández-Mondéjar, E.; Aguayo-Hoyos, Eduardo; Linde-Valverde, Carmen M.

doi:10.1097/00003246-200005000-00018

Cited by 129 publications

(71 citation statements)

References 30 publications

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“…[26,27] Hidden PNX incidence was 3.7% in trauma children presenting to the ED and was 64% after TT in multitrauma patients. [28,29] Hidden PNX diagnosis was reported in 54.8% of chest trauma cases. [18] In our study, out of the twenty-five PNX diagnoses, 15 (60%) could not be detected in APCR and 3 (12%) could not be detected in US.…”

Section: Discussionmentioning

confidence: 99%

A Study on the Evaluation of Pneumothorax by Imaging Methods in Patients Presenting to Emergency Department for Blunt Thoracic Trauma

Kaya

Çevik

Acar

et al. 2015

Ulus Travma Acil Cerrahi Derg

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BACKGROUND: Pneumothorax (PNX) is the collection of air between parietal and visceral pleura, and collapsed lung develops as a complication of the trapped air. PNX is likely to develop spontaneously in people with risk factors. However, it is mostly seen with blunt or penetrating trauma. Diagnosis is generally confirmed by chest radiography [posteroanterior chest radiography (PACR)]. Chest ultrasound (US) is also a promising technique for the detection of PNX in trauma patients. There is not much literature on the evaluation of blunt thoracic trauma (BTT) and pneumothorax (PNX) in the emergency department (ED). The aim of this study was to investigate the effectiveness of chest US for the diagnosis of PNX in patients presenting to ED with BTT

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Section: Discussionmentioning

confidence: 99%

A Study on the Evaluation of Pneumothorax by Imaging Methods in Patients Presenting to Emergency Department for Blunt Thoracic Trauma

Kaya

Çevik

Acar

et al. 2015

Ulus Travma Acil Cerrahi Derg

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“…In general, The CCT is superior to routine screening CxR with regard to sternal, rib and spine fractures, lung lacerations and contusions, pneumothorax, hemothorax, heart, pericardium, aorta and diaphragm (Guerrero-Lopez et al, 2000, Rivas et al, 2003. However, it is not clear whether CT chest should be used in the general blunt trauma population routinely or on selective basis.…”

Section: Commentmentioning

confidence: 99%

“…For example, the finding of an aortic or great vessel injury or spine fracture would mandate critical management or diagnostic manoeuvres, while the diagnosis of an occult pneumothorax may not (Brazel et al, 1999). Therefore, use of CCT in Selected patients can lead to significant changes in patient management (18-41%) (Trupka et al, 1997;Guerrero-Lopez et al, 2000;Renton, 2003;Salim et al, 2006;Deunk et al, 2007) while application of CCT more liberally results in little consequential intervention overall (Blostein and Hodgeman, 1997;Plurad et al, 2007;Wisbach et al, 2007) based on these occult diagnoses. On the other hand, others argue that the highe r d i s c o v e r y o f i n j u r i e s w i t h C T i s o f questionable clinical significance at great costs.…”

Section: Commentmentioning

confidence: 99%

Routine CT- Chest in Primary Evaluation of the Major Blunt Trauma Patients; Pros and Cons

Hamad¹

2011

CT Scanning - Techniques and Applications

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“…Alla radiografia del torace si evidenziano, spesso tardivamente, addensamenti polmonari irregolari, talora con coesistente pneumoed emotorace. La TAC toracica dimostra una sensibilità molto superiore nel definire precocemente i danni parenchimali, la loro topografia o la coesistenza di altre lesioni (ad esempio i grossi vasi) 28 . L'edema interstiziale di tipo lesionale o traumatico, quando raggiunge, come in genere accade, il piano pleurico, determina la comparsa di linee B.…”

Section: Contusione Polmonareunclassified

Pulmonary scan

Copetti

Soldati²

2006

Emerg Care J

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For many years it was believed that due to their air content, it was not possible to examine the lungs using ultrasound. However, notwithstanding the wealth of literature produced over the last ten years has shown the considerable potential of ultrasound in diagnosing pulmonary disease, pulmonary ultrasound is still a little known and rarely used technique. Chest radiography has long been and still largely remains the diagnostic method of choice in lung disease. However, it is well known that, especially in emergency situations, radiological imaging is unsatisfactory as regards the standard required, with consequent further difficulties in interpreting the clinical situation. Chest x-rays performed in emergency departments frequently involve non-cooperative and/or bed-ridden patients. It is not always possible to obtain a lateral projection and the postero-anterior projection is performed in orthostatic conditions. In addition to these limits deriving from pictures obtained in non-optimal conditions, there are also intrinsic limits, such as an opaque hemithorax cannot always be precisely attributed to parenchymal or pleural pathology and widespread expansion of the interstitial space may mean many things, from pulmonary stasis to the great variety of interstitial diseases. Pulmonary CT is considered a diagnostic gold standard and yet it entails the transportation of patients that are often instable, exposure to high doses of ionising radiation (the equivalent of 100-200 chest x-rays), high costs and risks connected to iodate agents. Pulmonary ultrasound would appear promising especially in emergency medicine, as particularly in such contexts the immediate availability of diagnostic means, the simplicity of execution and interpretation of the images are all important

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Evaluation of the utility of computed tomography in the initial assessment of the critical care patient with chest trauma

Abstract: TCT detects more chest injuries in trauma patients than does CXR and induces therapy changes in a considerable number of patients. However, this does not translate into an improvement in clinical outcomes.

Cited by 129 publications

References 30 publications

A Study on the Evaluation of Pneumothorax by Imaging Methods in Patients Presenting to Emergency Department for Blunt Thoracic Trauma

A Study on the Evaluation of Pneumothorax by Imaging Methods in Patients Presenting to Emergency Department for Blunt Thoracic Trauma

Routine CT- Chest in Primary Evaluation of the Major Blunt Trauma Patients; Pros and Cons

Pulmonary scan

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